Trauma bypass protocols being developed for south-east

The HSE National Office for Trauma Services is working with the National Ambulance Service (NAS), local hospital management and Hospital Groups to plan for the implementation of trauma and orthopaedic bypass protocols for the south-east.

A HSE spokesperson told the Medical Independent (MI) the NAS had successfully completed a pilot for trauma patients to bypass Naas General Hospital and this is now an established process.

Patients meeting the bypass criteria are transported to a trauma hospital, according to the HSE spokesperson. “In the case of the Naas catchment area, emergency ambulances were and are directed to trauma access according to each hospital’s capabilities. The hospitals were and are Tallaght University Hospital and the Midlands Regional Hospital, Tullamore.”

In accordance with A Trauma System for Ireland: Report of the Trauma Steering Group, published in 2018, patients with trauma and orthopaedic injuries will be brought to hospitals with on-site trauma and orthopaedic services.

The Naas pilot was referenced in briefing documents for Minister for Health Stephen Donnelly. The documents also referred to the introduction of further bypass protocols to follow in 2020 in regard to Clonmel, Wexford, Kilkenny, and Cavan.

A “high level plan” for the implementation of the trauma strategy is in development. Resources associated with the plan will be subject to approval through the annual HSE estimates process, according to the Executive spokesperson.

A National Clinical Lead for Trauma Services, Mr Keith Synnott, was appointed in 2019.

The trauma strategy indicated that around 30 per cent of major trauma patients may arrive at a hospital not appropriate to their care needs. It recommended that the HSE implements a hub-and-spoke trauma system comprising of two regional trauma networks. One major trauma centre should be located in Dublin and the other at Cork University Hospital, according to the report.

“Following a public consultation and review of hospital submissions by the independent assessment panel (IAP), the board of the HSE accepted the advice of the IAP and made a recommendation to the Minister for Health on the hospitals to be designated as the major trauma centre for the central trauma network and the Dublin trauma units,” stated the HSE’s spokesperson.

A Department spokesperson told MI “the matter is under consideration” and it is engaging with the HSE.